1. Technical Field
The present invention generally relates to equipment used during rehabilitation of spinal and otherwise injured patients. More specifically, the present invention relates to an apparatus for assisting a patient to perform walking motion by connection of the apparatus between the legs of an injured patient and the legs of an attendant.
2. Background Information
Rehabilitation for victims of leg paralysis resulting from spinal cord injury requires using equipment that gives a paralyzed patient the opportunity to revitalize dormant muscles during relatively normal physical activity. Physical therapy for these patients has begun employing exercise assemblies such as treadmills that are normally associated with health and fitness clubs and the like.
In one application, a patient wears a body harness that supports the pelvic area and the upper torso while using a specially adapted treadmill. A strap extending from each shoulder to above the head of the patient attaches to an overhead support bar that is part of a support frame. A cable and pulley arrangement is activated to draw the shoulder straps up towards the support bar. This apparatus exerts an upwardly directed force on the patient in magnitude up to and including the point at which all weight has been counteracted and therefore removed from the patient""s legs. Positional adjustment of the support frame allows the patient""s feet to rest on the flat surface of the treadmill.
Once the treadmill begins to move the patient""s feet contacting the flat surface are drawn along by the movement. In order to perform a walking motion, the patient traditionally has required assistance from one or more attendants. When performing such a therapeutic procedure, each attendant occupied a position by the side of the treadmill from which they could reach, lift and move the patient""s legs in a motion that mimicked the walking process. A paraplegic required two attendants occupying positions on both sides of the treadmill in order to lift and move the patient""s legs through the correct actions for walking. Alternatively, each attendant placed a foot of the patient in a forward position ahead of the patient""s body. Normal, linear movement of the treadmill then displaced the foot to a position behind the patient. Completion of each attendant-assisted movement represented one stride for the patient. When a striding foot reached its rearmost position, the attendant on that side of the patient again lifted the foot from the flat surface of the treadmill and pulled it forward back to the starting position readied to allow the treadmill to effect another stride. The process of assisted walking of the suspended patient would continue giving the patient the opportunity to attempt to xe2x80x9clearnxe2x80x9d the waking process over again, while simultaneously strengthening their legs from the effort they are able to contribute during the therapy session.
The use of this technique for rehabilitation by reintroducing spinal injury sufferers to the familiar motion and pleasure of walking has been encouraging in terms of its results. For example, a hemiplegic, i.e., one who retains control over one leg, may perform a walking motion with assistance from only one attendant. The attendant repositions the injured leg while the patient still controls and moves his or her functioning leg. As indicated above, a paraplegic requires two attendants, i.e., one for each leg. Further, a quadriplegic requires even additional attendants for steadying the suspended body while the walking therapy is in progress.
A scarcity of skilled attendants limits the number of patients who may benefit from this type of rehabilitating treatment. This has led to attempts to develop mechanical devices that may assist with the walking process in the absence of an attendant.
One such device is a jointed leg brace that includes computer controlled actuators for moving sections of the brace in a way that simulates the gait of a walker. The brace is a complicated structure that must be strapped to a patient""s hip, as well as outside the patient""s leg in three locationsxe2x80x94at the thigh, just above the calf and at the ankle. One or two braces may be used, depending upon the patient""s condition. As before, the patient wears a harness for suspension by a frame with his or her feet resting on the flat surface of a treadmill. As the treadmill moves, the computer controlled brace performs strides by appropriately lifting and placing the patient""s legs relative to the moving treadmill.
This use of computer controlled equipment presents at least two potential disadvantages. Firstly, there is the associated cost, which includes an expensive, computer assisted mechanical structure and its associated maintenance. Such a mechanical structure may be at least as expensive as the use of multiple rehabilitation attendants. Secondly, there is the possibility of computer or equipment malfunction that, in extreme cases, could lead to further injury of an unattended patient.
In view of the above described deficiencies associated with the use of known designs for assisted walking rehabilitation equipment and procedures, the present invention has been developed in order to alleviate these drawbacks and provide further benefits to the user. These enhancements and benefits are described in greater detail herein below with respect to several alternative embodiments of the present invention.
The present invention in its several disclosed embodiments alleviates the drawbacks described above with respect to conventionally designed rehabilitation equipment. It incorporates several additionally beneficial features that simplify therapy procedures and lower costs by reducing attendant-to-patient ratio.
Rehabilitation procedures according to the present invention require the use of equipment and apparatus to assist a patient paralyzed by spinal or other trauma, such as strokes or other illnesses, to perform a walking motion. An attendant supervises and works with the patient in exercise activities related to walking. Equipment used during supervised exercise includes a body harness worn by the patient and a treadmill. The body harness attaches to an overhead support that bears an adjustable portion of the weight of the patient while allowing contact between the patient""s feet and the movable belt of the treadmill. A supervising attendant takes a position on the treadmill either in front of or behind the patient.
Before exercise begins, connection is made between the healthy legs of the attendant and the injured legs of the patient using rehabilitation apparatus according to the present invention. The rehabilitation apparatus includes a leg appliance and ankle appliance worn by the attendant and patient, with separate linkage between the leg appliances and the ankle appliances. A single piece of apparatus comprises two leg appliances adapted for interconnection between the attendant and patient, as well as two ankle appliances also adapted for interconnection between the patient and attendant. One or two pieces of rehabilitation apparatus may be used depending on the need for treatment to one or both of the patient""s legs. For example, an injured left leg would require connection of the left leg of the patient to the left leg of the attendant. A paraplegic patient would require both legs to be connected to the legs of the attendant.
After positioning and connecting the rehabilitation apparatus between the patient and attendant, the treadmill may be energized causing the belt to move. As the belt slowly moves, the attendant begins to walk. The rehabilitation apparatus transmits the walking motions of the attendant through the connected leg appliances and linked ankle appliances to the patient""s legs, depending on which are connected. Each step taken by the attendant at a position walking behind or in front of the patient causes stepping motion to be induced in and performed by the patient under the motivation and control of the rehabilitation apparatus. While an attendant""s healthy legs lift and reposition a patient""s injured legs, the attendant positioned behind the patient may also reach forward to the patient above the waist to assist with stability and weight transfer as the patient attempts to re-develop their ability to walk. The positioning of the attendant and use of the rehabilitation apparatus provide a much improved approach to increasing the confidence and desire of a patient to regain their ability to walk unaided.
More particularly, the present invention provides an apparatus adapted for coupling between an able-bodied attendant positioned behind a patient for rehabilitation of a leg damaged by paralysis. The apparatus comprises a leg appliance secured to a patient""s shin, with a leg bracket adjacent to the patient""s knee. A leg appliance or brace secured to an attendant""s shin also includes a bracket adjacent to the knee. At least one connecting rod provides coupling from the leg bracket to the bracket of the leg brace to transmit motion from an attendant""s leg to a patient""s leg using forces acting from the leg brace to the leg appliance through the connecting rod.
An ankle appliance having an upper extension and a lower extension proximate the ankle is attached to a patient""s foot and an ankle brace is similarly attached to an attendant""s foot. The ankle brace has a brace upper extension and a brace lower extension adjacent the ankle of the attendant with the brace upper extension coupled by an upper ankle link to the upper extension of the patient""s ankle appliance, while the brace lower extension is coupled by a lower ankle link to the lower extension of the ankle appliance. An offset link is connected to the attendant""s or patient""s ankle brace. This link extends rearwardly, where it slidably engages with a stationary support. This arrangement assists the attendant in transferring side-to-side foot motions to the patient without undue twisting or stressing to the ankle and leg of the attendant. Each of the upper link and the lower link are adapted to create movement of a patient""s foot corresponding to movement of a foot of an attendant during walking whereby coordinated leg and ankle movement allows a patient""s paralysis damaged leg to duplicate the walking motion of an able-bodied attendant""s leg. It should be appreciated that the apparatus not only provides for the proper leg extension and foot placement for the walking action, but also utilizes appropriate parallel connections and link for communicating the tilting and side-to-side motions, respectively, of the foot as it moves through a step.
The beneficial effects described above apply generally to the exemplary devices and mechanisms disclosed herein of the rehabilitation apparatus for spinally injured patients. The specific structures through which these benefits are delivered will be described in detail herein below.